SENIOR MANAGER OUTPATIENT CODING

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.

Reporting to the Associate Director, Coding this position is responsible for the system-wide day-to-day oversight of Outpatient Clinical Coding (specifically Same Day Surgery, ED facility and professional coding, Denial Management, Claims Editing, Observation, and Provider-based coding. The Sr. Manager is responsible for the optimization of workflow, Epic Optimization, and the overall quality of outpatient coding coupled with meeting and exceeding DNFB metrics for the system.

EEO/AA Minority/Female/Disability/Veteran

 

*CB

Responsibilities

  • 1. Provides direction to manager and supervisors of the outpatient coding area ensuring the timely and accurate coding and billing of claims.
  • 2. Manages enterprise wide outpatient coding and claim errors including provider-based clinics.
  • 3. Organize and implement system-wide centralized outpatient coding functions for efficient and effective operations.
  • 4. Manage outpatient denials for APCs and Authorizations for all entities in addition to the outpatient RAC and payer audits.
  • 5. Develop and implement staffing plan to meet work volume and changing workforce dynamics.
  • 6. Develop policies, procedures and standards that direct outpatient coding operations.
  • 7. Implement the Remote Coding Program across the System within the outpatient coding area.
  • 8. Promote professional growth, development and accountability in staff, students and colleagues.
  • 9. Develop a feeder program for outpatient coding staff recruitment working collaboratively with Coding Educator to mentor students who can progress to the Apprenticeship role.
  • 10. Serve as the HIM Coding outreach representative to work collaboratively transitioning staff from Provider offices to Hospital based employees.
  • 11. Responsible for the timely and complete coding of Emergency Department visits at all entities within the Yale New Haven Health System including provider based clinics
  • 12. Responsible for managing and directing the work activities of employees responsible for denial analysis and resolution for all APC denials and managed care authorization rejections at all Health System Hospitals and provider based clinics.
  • 13. Responsible for managing and directing the work activities of employees responsible for denial analysis and resolution for all Outpatient RAC and Payer audits at all Health System Hospitals and provider based Clinics.
  • 14. Responsible for transitioning outpatient coding staff from coding within legacy system to EPIC. Ensures appropriate training, productivity and optimum workflow is in place prior to go-live.
  • 15. Responsible for transitioning outpatient coders from hospitals and other facilities to System.
  • 16. Serve as Project Manager for the successful operational implementation of the Lynx EDI application. Collaborate with IT and Vendor to ensure successful technology transition that ensures no delay in coding and billing.

Qualifications

EDUCATION

 

Bachelor's degree required or successful completion of degree within 12 months of promotion. Master's degree is desirable. Certification: Certified Coding Specialist (CCS) required.

 

EXPERIENCE

 

Eight (8) years progressive work experience in a managerial responsibility for HIM Outpatient Coding. Experience implementing technology based projects. Applicant must possess strong presentation skills.

 

SPECIAL SKILLS

 

Well developed communication skills, analytical skills, and use of Microsoft Office tools. Possesses a strong knowledge of coding, billing and charging industry standards. Ability to work with a diverse group of clinicians, ancillary departments, and office staff.

 


See Inside the Office of Yale New Haven Hospital

Yale New Haven Hospital provides diverse comprehensive care in over 100 medical specialties. As the primary teaching hospital of the Yale School of Medicine, YNHH provides around-the-clock coverage and insightful, research-supported patient care. In addition to providing quality medical care to patients and families, Yale New Haven Hospital is the second largest employer in the New Haven area, with more than 12,000 employees.


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